OBJECTIVES: Several studies regarding efficacy, cost and cost-effectiveness analysis of new treatments of Hepatitis C (HCV) have been published. The new era of Direct Antiviral Agents (DAA) allow patients to be cured of HCV. However, in low and middle-income countries, not all new DAA have been approved or reimbursed. The objective of this research is to estimate the cost of not provide treatment for people infected with HCV.

METHODS: The study design was a cost analysis from the Mexican health system perspective. Based on previous studies, a Markov simulation model in a 25 years’ time horizon was developed. We considered each Fibrosis stage (F0-F4), hepatocellular carcinoma, decompensated cirrhosis, liver transplant and death as health states. Transition probabilities were based on a natural history of disease model previously published. All patients began at F0 stage. Costs for specific disease states were obtained from the Diagnosis-Related Groups published by the Mexican Institute for Social Security. Costs were expressed in 2018 USD. We divided cost per no treated person with and without a liver transplant. Costs at 5, 10 and 25 years were analyzed.

RESULTS: The cost of an HCV-infected person that requires a liver transplant is around $95,000 USD ($50,000 without the liver transplant) in a 25 years horizon. At year 5, costs per no treated person are $12,000 USD, while at year 10 is $22,000 USD. Treatment costs for HCV-infected people are around $9,000 USD, therefore, provide HCV-treatment is a cost-saving intervention for the Mexican health system.

CONCLUSIONS: In the era of new DAA, provide treatment to HCV-patients generate savings compared to not provide it. Low and middle- income countries may consider HCV-treatment as a cost-saving intervention for the health system not only in a long-term horizon, but in 5-10 years. Economic impact of no treatment is higher than treatment costs.